Stent Graft in the Treatment of Pseudoaneurysms of the Hepatic Arteries

Lü, Peng-Hua; Zhang, Xicheng; Wang, Lifu; Chen, Zhaolei; Shi, Haibin

doi:10.1177/1538574413488460

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…Other noniatrogenic causes of HAPs include trauma, acute and chronic pancreatitis, arteriosclerosis, PAN, necrotizing vasculitis, infection and hepatocellular car cinoma [2,3,810] . Recent increases in the incidence of HAPs have been attributed to a rise in the number of liver transplantations, percutaneous liver and gallbladder interventions and the use of laparoscopic surgery [1,4,9,11] . Advances in imag ing techniques have enhanced the detection rate of asymptomatic HAPs [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Recent increases in the incidence of HAPs have been attributed to a rise in the number of liver transplantations, percutaneous liver and gallbladder interventions and the use of laparoscopic surgery [1,4,9,11] . Advances in imag ing techniques have enhanced the detection rate of asymptomatic HAPs [1] . While HAPs may be an incidental finding in an asymptomatic patient, more commonly patients present with abdominal pain, anemia, hemobilia, melena, and can present as lifethreatening hemorrhage following rupture [2,8,11] .…”

Section: Discussionmentioning

confidence: 99%

“…Numerous case reports have been published addressing the occurrence of HAPs subsequent to a variety of interventional procedures including cholecystectomy, pancreaticoduodenectomy, and orthotopic liver transplant. It has been hypothesized that with the increasing frequency of laparoscopic procedures, such as cholecystectomy, which can result in inadvertent injury to the right hepatic artery, the overall incidence of HAPs will continue to rise [1,3] . Due to the increased risk of rupture compared with true aneurysms, some have advocated intervention in all cases of identifiable visceral pseudoaneurysm [4] .…”

Section: Introductionmentioning

confidence: 99%

“…Due to the increased risk of rupture compared with true aneurysms, some have advocated intervention in all cases of identifiable visceral pseudoaneurysm [4] . It has been reported that HAPs have been successfully treated using a variety of interventional methods, including endovascular embolization, coiling embolization, and arterial stent grafting [1,2] . Because of the increased morbidity associated with surgery in this setting, surgical management is the final treatment option when these subsequent methods have failed.…”

Section: Introductionmentioning

confidence: 99%

“…Hepatic artery pseudoaneurysms (HAPs), or false aneury sms, classically arise secondary to trauma or iatrogenic causes and pose a serious risk of exsanguinating hemo rrhage and subsequent death [1,2] . Numerous case reports have been published addressing the occurrence of HAPs subsequent to a variety of interventional procedures including cholecystectomy, pancreaticoduodenectomy, and orthotopic liver transplant.…”

Section: Introductionmentioning

confidence: 99%

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Atypical presentation of a hepatic artery pseudoaneurysm: A case report and review of the literature

Luckhurst

Perez

Collinsworth

et al. 2016

WJH

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Classically, hepatic artery pseudoaneurysms (HAPs) arise secondary to trauma or iatrogenic causes. With an increasing prevalence of laparoscopic procedures of the hepatobiliary system the risk of inadvertent injury to arterial vessels is increased. Pseudoaneurysm formation post injury can lead to serious consequences of rupture and subsequent hemorrhage, therefore intervention in all identified visceral pseudoaneurysms has been advocated. A variety of interventional methods have been proposed, with surgical management becoming the last step intervention when minimally invasive therapies have failed. The authors present a case of a HAP in a 56-year-old female presenting with jaundice and pruritis suggestive of a Klatskin's tumor. This presentation of HAP in a patient without any significant past medical or surgical intervention is atypical when considering that the majority of HAP cases present secondary to iatrogenic causes or trauma. Multiple minimally invasive approaches were employed in an attempt to alleviate the symptomology which included jaundice and associated inflammatory changes. Ultimately, a right hepatic trisegmentectomy was required to adequately relieve the mass effect on biliary outflow obstruction and definitively address the HAP. The presentation of a HAP masquerading as a malignancy with jaundice and pruritis, rather than the classic symptoms of abdominal Luckhurst CM et al . Hepatic artery pseudoaneurysm presenting as Klatskin's tumor pain, anemia, and melena, is unique. This presentation is only further complicated by the absent history of either trauma or instrumentation. It is important to be aware of HAPs as a potential cause of jaundice in addition to the more commonly thought of etiologies. Furthermore, given the morbidity and mortality associated with pseudoaneurysm rupture, intervention in identifiable cases, either by minimally invasive or surgical interventions, is recommended.

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